前路减压、植骨及内固定治疗胸腰椎爆裂骨折

目的探讨胸腰椎爆裂骨折前路减压固定的可能性。方法2001年5月￣2005年1月,收治32例胸腰段骨折合并脊髓损伤患者。其中T1212例,L117例,L23例。按Franke1分级评定:A级6例,B级5例,C级7例,D级14例。手术均行前路减压内固定术。结果32例术后影像学检查胸腰椎生理弧度基本恢复正常。均获随访10～51个月,平均17.9个月。神经功能除2例脊髓完全损伤无恢复外,其余均有不同程度改善。未出现钢板螺钉松动断裂、继发性脊柱后突及节段性不稳等并发症。结论前路减压内固定修复重建严重胸腰椎爆裂骨折,具有减压彻底、植骨充分及内固定牢固等特点,有助于椎体高度恢复和神经功能改善。

Anterior decompression and bone grafting with internal fixation for thoracolumbar burst fractures

[Objective] To explore the possibility of anterior decompression with internal fixation for thoracolumbar burst fractur. [Methods] From May 2001 to January 2005, 32 patients with thoracolumbar burst fracture with spinal cord injuries were treated. The fractures were located at T12 in 12 patients, L1 in 17, L2 in 3. All patients were treated with anterior decompression and bone graft with internal fixation. [Results] In 32 patients thoracolumbar curve were restored to the normal physiological angle. They were followed up for 10~51 months(means 17.9 months). The spinal cord function was improved in all the patients except 2. There were no such complications as plate screw loosening or breaking, or segment instability. [Conclusions] The operation of the anterior decompression with internal fixation for severe thoracolumbar burst fracture has advantages of complete decompression, full bone-grafting, and firm internal fixation. It can restore the spinal height and improve the spinal cord function.